Background: Acute kidney injury (AKI, previously known as acute renal failure) is a frequent complication that affects a substantial number of hospitalized patients annually. However, the relationship between severity of AKI and in-hospital outcomes in the setting of acute Acute ST-Elevation Myocardial Infarction (STEMI) has not been well- documented. Chronic kidney disease is a strong predictor of in-hospital mortality in the acute myocardial infarction setting. Objective: To evaluate the Outcome of admitted patients of acute ST elevation myocardial infarction with renal function. Methods: The Prospective observational study was carried out at the Cardiology Department, Bangabandhu Sheikh Mujib Medical College and Hospital, Faridpur, Bangladesh from July 2020 to June 2021. 100 patients of STEMI diagnosed by clinical, biochemical and ECG criteria were included in the study. After getting serum creatinine level from them, eGFR was calculated and patients having <60ml/min were selected for the further studies. Results: In the STEMI patients, the ratio of male patients 76% and females’ patients (35%) was 3.34:1 with mean ± SD of age was 52.84 ±8.40 year. Among the 101 patients, chart indicating the outcome of the study patients where cardiogenic shock was found in 10.8% patients, heart failure was found in 24.7%, arrhythmias were found in 69.3% and death occurred in 5.9% of cases. Table 5 showing Stratification of patients by in relation with eGFR where different pattern and frequency of outcome was observed in relation with level of eGFR described. After calculating levels of eGFR, all the outcomes showed statistically significant (P < 0.05) except cardiogenic shock which didn’t show significance (P > 0.05. Conclusion: In concluded, that those who have renal impairment previously or develop after acute STEMI have inverse outcomes. As renal impairment is associated with an increased risk of coronary artery disease and stroke, the cardiovascular disease may develop early in the course of renal dysfunction.
Introduction: Globally, an annual estimate of over 7 million deaths occurs due to Coronary Artery Disease (CAD) - the leading cause of Cardiovascular (CV) morbidity and mortality. Multivessel coronary artery disease (MVD) is defined as luminal stenosis of at least 70% in at least two major coronary arteries or in one coronary artery in addition to a 50% or greater stenosis of the left main trunk. Methods: A prospective observational study was carried out at Department Of Vascular Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from January to December 2021. Out of 286 individuals younger than 60 years old admitted to the outpatient clinic with chest pain and referred for coronary angiography were included in the study. All clinical and biochemical parameters were documented in the hospital records. Coronary angiography of patients was monitored from records. The individuals were divided into two groups. The patient group consisted of 182 individuals with at least one-vessel stenosis of ≥70%, and the control group consisted of 104 individuals with normal coronary angiography. We compared the traditional and nontraditional risk factors of these two groups in terms of the presence of CAD. Results: Prevalence of male sex and smoking were higher in the patient group, and the prevalence of hypertension and diabetes were similar in the two groups. In the patient group, mean age, blood cholesterols, serum gamma-glutamyl transferase, hemoglobin, and white blood cell and lymphocyte levels were higher, while estimated glomerular filtration rate (eGFR), high-density lipoprotein cholesterol (HDL-C), platelets, and neutrophil/lymphocyte and platelet/lymphocyte ratios were lower. Low eGFR and HDL-C levels, older age, male sex, smoking, and high levels of low-density lipoprotein cholesterol and lymphocytes were independent risk factors for the presence of CAD in young patients. Conclusion: In conclusion, contrary to studies done in the patients, ............
Background: Electrical accidents (EA) are rare, but can cause serious and potentially life-threatening injuries to multiple organs. The majority of epidemiological data refers to workplace accidents which account for a significant share of such accidents in adults. Exposure to electric shock has been associated with an increased risk of developing immediate and delayed cardiac arrhythmias. Objective: To evaluate the prevalence of cardiac arrhythmias and different symptoms in patient with high voltage and low voltage electrical injury. Methods: This was observational prospective study was carried out at the Dept. of Cardiology, Bangabandhu Sheikh Mujib Medical College Hospital, Faridpur, Bangladesh from January to June 2021. 51 consecutive patients with electrical injury who were admitted. Admission criteria were age ≥15 years, loss of consciousness, cardiac arrest, electrocardiographic abnormalities, soft tissue damage and burns. Patients were categorized into high and low voltage injury group and their variables were compared. Results: The mean age of the patients was 32.3±10.4 years among them 41 (82.3%) were male. Patients who sustain high voltage electrical injury (>1000V) were 18 (35.2%) and low voltage injury (<1000V) were 33 (64.7%).Cardiac arrhythmias like sinus tachycardia (11.1% vs 6.0%, p=0.054), sinus bradycardia (11.1% vs 3.0% p=0.254), ventricular premature beats (5.6% vs3.0%, p=0.674), atrial fibrillation (11.1% vs 0%, p=0.054) were observed in high voltage and low voltage group. The commonest presenting symptoms in both groups were pain (77.8% vs 81.8% p=0.560) and fatigue (55.6% vs 39.3%, p=0.328). Conclusion: In this study few non-fatal cardiac arrhythmias were observed in both high and low voltage electrical injury group. Parameters considered to be risk factors such as known structural heart disease, loss of consciousness, high voltage electric shock, burn and soft tissue injuries were also not significant predictors of the occurrence of arrhythmias. There is no significant difference in the presenting symptoms and types of arrhythmias observed between low voltage and high voltage injury group.
Background: Chest pain not yet diagnosed), has been introduced in order to describe the subset of patients without coronary ischemic etiology of their chest pain. Chest pain is one of the common reason and Acute coronary syndrome is an important cause of chest pain. Objective: To assess the Prevalence of Acute Coronary Syndrome among Patients Presenting with Chest Pain and its association with common cardiovascular risk factors. Methods: This was an observational study conducted at Faridpur Medical College Hospital, Faridpur, Bangladesh from January to June 2022 enrolling 224 participants consecutively. Participants were interviewed focusing history of hypertension, diabetes, smoking and nature of chest pain. The diagnosis of participants whether it was acute coronary syndrome or not were recorded. Prevalence of acute coronary syndrome was calculated. Linear regression analysis was done to see the correlation with tested variables. Results: Out of 224 participants, 150 (66.96%) were male. Hypertension was present in 84 (37.5%), diabetes in 60 (26.78%) and 52 (23.21%) were smoker. Mean age was 51.82±14.24 years. Seventy-five (66.96%) were male. Forty-two (37.5%) were hypertensive, 60 (26.78%) were diabetes and 52 (23.21%) were smoker. Fifty-six (50%) had nonspecific chest pain, 70 (31.25%) had atypical chest pain and 42 (18.75%) had typical chest pain. Among the participants 76 (33.93%) had acute coronary syndrome. Acute coronary syndrome showed positive correlation with age, gender, nature of chest pain, hypertension and smoking. Conclusion: Acute coronary pattern was one of the common cause of casket pain among actors visiting exigency of a tertiary cardiac centre. We set up positive correlation of age, gender, nature of casket pain, hypertension and smoking with opinion of ACS. Cases with these threat factors need strong dubitation of ACS and prompt work up when they present with casket pain so that they can get proper operation on time.
Introduction: Obesity is a major health problem in western society with rapidly increasing prevalence in most countries. The healthcare burden of obesity is far reaching but many of the consequences are yet to be fully understood. While there is a perception that obesity negatively impacts on outcomes following abdominal surgery there is conflicting evidence for this. Aims: To identify the complications of post-operative obese patients. Methods: Between 1st September, 2016 and 28th February, 2017, patients undergoing GIT, Hepatobilliary and Urological surgery at Shaheed Ziaur Rahman Medical College Hospital in Bogura, Bangladesh were enrolled. Following informed consent, BMI was assessed. High risk patients and complications were identified according to established criteria. Patients were grouped according to BMI categories as Normal, overweight, Obese grade-I and Obese grade-II. A Cost analysis was performed on all patients treated at Shaheed Ziaur Rahman Medical College Hospital using a SQL database. The cost of treatment was analysed with respect to the same BMI catagories. Results: A literature review found evidence of increased risk of wound infection, anastomotic leak, and pulmonary and thrombo-embolic risk. There was mixed evidence or no evidence that obesity increases cardiac risk, sepsis, overall morbidity and mortality or overall cost. A cohort of 100 patients was analysed. Diabetes was more common with increased BMI (p=0.017). Other categories of operative risk were not different. There was no difference in overall morbidity (p=0.903). Obese patients were more expensive than normal weight patients ($9587 versus $5,786(p<0.05)). Conclusion: This study demonstrates that obesity, measured by BMI is associated with more severe morbidity. I have also demonstrated that excess body fat as measured by BMI is associated with a significantly increased cost of treatment (36%) for patients undergoing major abdominal surgery.
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